MEDICARE: MICHELLE FRAZIER LCSWC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker	LC303431	DC
2	1041C0700X	Clinical Social Worker	24522	MD

General Provider Information

NPI Number	:	1285258939
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MICHELLE FRAZIER LCSWC

Provider Business Mailing Address
First Line	:	8876 OSTERLY CT
Second Line	:
City	:	WHITE PLAINS
State	:	MD
Zip	:	20695-4425
Country	:	US
Telephone Number	:	301-710-4219
Fax Number	:

Provider Business Practice Location Address
First Line	:	508 KENNEDY ST NW UNIT 2
Second Line	:
City	:	WASHINGTON
State	:	DC
Zip	:	20011-3137
Country	:	US
Telephone Number	:	202-223-9630
Fax Number	:	202-223-9632

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/28/2020
Last Update Date	:	04/12/2023

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Directions to “ MICHELLE FRAZIER LCSWC” Practice Location

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